Hearing Prosthesis Programming via ECoG Stapedius Reflex Detection
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Solution Overview
Problem
Conventional methods for determining the dynamic range of electrical stimulation in hearing prostheses, such as cochlear implants, are recipient-specific and often require complex clinical procedures, making it difficult to administer effective fitting and programming, especially for young children or those unable to communicate effectively.
Innovation Solution
The use of electrocochleography (ECoG) measurements to determine the upper limit of the dynamic range by incrementally increasing electrical stimulation current levels and monitoring acoustically evoked responses, including the stapedius reflex, to objectively set comfort levels for implanted stimulating contacts, allowing for automated or remote operation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional clinical procedures are used to determine dynamic range, then recipient-specific accuracy is improved, but procedure complexity and difficulty of administration increase
Solution Approach 1:
The system performs self-measurement of the stapedius reflex threshold using automated ECoG monitoring. The hearing prosthesis itself delivers the acoustic stimulus and monitors the electrical response, eliminating the need for complex external clinical equipment and specialized operators. The processor automatically determines the threshold from the ECoG signal changes, enabling the system to perform the measurement function independently.
Solution Approach 2:
The patent replaces complex mechanical clinical procedures with electrical measurement methods. Instead of using complicated mechanical apparatus for threshold determination, the system uses electrical stimulation and ECoG monitoring to detect stapedius reflex threshold, simplifying the measurement system while maintaining or improving accuracy.
2Measurement precision
If conventional clinical procedures are used to determine dynamic range, then measurement accuracy is improved, but ease of operation decreases
Solution Approach 1:
The hearing prosthesis automatically performs the comfort level determination by monitoring ECoG responses to acoustic stimuli. The system self-calibrates by detecting the stapedius reflex threshold and using this information to establish appropriate electrical stimulation parameters, eliminating the need for manual clinical intervention and making the fitting process easier to administer.
Solution Approach 2:
The system uses real-time feedback from ECoG measurements to automatically adjust and determine comfort levels. The processor continuously monitors the electrical response of the cochlea to acoustic stimuli and uses this feedback to identify the stapedius reflex threshold, thereby automatically establishing appropriate stimulation parameters without requiring complex manual procedures.
3Ease of operation
If automated ECoG monitoring is used to determine comfort levels, then ease of operation is improved, but measurement precision may worsen
Solution Approach 1:
The automated system maintains measurement precision through continuous feedback from ECoG monitoring. The processor analyzes the electrical responses in real-time and automatically identifies the stapedius reflex threshold based on characteristic changes in the ECoG signal. This feedback mechanism ensures accurate threshold determination even though the process is automated and easier to administer.
Solution Approach 2:
The patent replaces manual measurement techniques with automated electrical monitoring methods. The ECoG monitoring system electronically detects threshold changes with high precision, substituting subjective or manual assessment with objective electrical measurements, thereby maintaining accuracy while improving ease of operation.
4Adaptability or versatility
If incremental electrical stimulation is used with ECoG monitoring, then adaptability is improved, but use of energy increases
Solution Approach 1:
The system uses incremental electrical stimulation only to the extent necessary to elicit the stapedius reflex threshold response. Rather than applying continuous or excessive stimulation, the method applies just enough incremental electrical stimulus to trigger the reflex and detect the threshold via ECoG, thereby reducing overall energy consumption while still achieving the adaptation goal.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach provides a convenient and effective method for determining comfort levels at different stimulating contacts, enabling proper delivery of electrical stimulation and improving the fitting process for hearing prostheses, applicable to both children and adults, and can be performed without the need for specialized supervision.
Implementation Method 1
performing one or more electrocochleography (ECoG) measurements in response to the delivery of each set of electrical test stimulation
Implementation Method 2
monitoring an acoustic impedance of the cochlea in response to the incrementally increasing current levels via electrocochleography (ECoG) measurements
Data Source
AI summary
Presented herein are objective techniques for determining the upper limit of the dynamic range (i.e., the comfort level) of implanted stimulating contacts through the use of electrocochleography (ECoG) measurements to indirectly detect the onset and duration of a recipient's stapedius reflex. In particular, stimulation is delivered to a recipient's cochlea to trigger the onset of the stapedius reflex and the resulting acoustic impedance change is detected by monitoring the acoustically evoked ECoG.